Best Practices to Reduce Ventilator Associated Pneumonia

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What is the best evidence based nursing practice in attempting to reduce (VAP) ventilated associated pneumonia? I decided to do an evidence based paper on VAP after talking to respiratory therapy on the sixth floor of Chippenham hospital during my clinical studies. I have a friend who has spent many years as a RN in the critical care unit and has seen the effects of different methods in reducing VAP first hand. This is a nursing intervention and the sole responsibility of the nurse. I can’t think of a better topic to research considering I am in my first semester of nursing school. I am very excited to share what I have found. I have found a large amount of information on different methods to reduce VAP but have decided on three to discuss in my paper. Positioning, oral care and use of antibiotics are discussed in some detail throughout this paper. I have found three professional articles with emphasis on different case studies performed on reducing VAP and their outcomes.
A ventilator is a machine that helps a patient breathe by giving oxygen through a tube through the nose, mouth or through a hole in the front of the neck. VAP is pneumonia that develops 48 hours or longer after mechanical ventilation is given. It is the second most common hospital acquired infection. The mortality rate for VAP is 27-76%. In today’s nursing critical care units the prevention of nonsocomial ventilator associated pneumonia is a huge challenge. It costs the hospitals on average an additional $40,000.00 per patient when VAP is contracted. (Hospital stays become lengthened between 5 and 7 days. (Shakeel Amanullah, MD, 2009)
Shakeel Amanullah MD is a consulting physician and participates in Pulmonary, Critical Care, and Sleep Medicine at Lancaste...
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... day so if that patient can be taken off of the ventilator as soon as possible.
3. Clean and replacing all equipment between use on patients.
4. Oral Care.
5. Cleaning your hands after touching ventilator and or patient.
Works Cited
American College of Physicians. (August 2006). Annals of Internal Medicine.
Annie Ruest. (Nov/Dec 2006). COMMENTARY: Oral decontamination with chlorhexidine reduced ventilator-associated pneumonia in high-risk patients. ACP Journal Club , 68.
Louis Magnotti. (June 2008). Reduction in Inadequate Empiric Antibiotic Therapy for Ventilator-Associated Pnuemonia: Impact of a Unit-Specific Treatment Pathway. American Surgeon , Vol 74 Issue 6 pages 516-523.
Shakeel Amanullah, MD. (2009, April 16). Atypical Bacterial Pneumonia Imaging. Retrieved from Medscape Reference: http://emedicine.medscape.com/article/363083-overview

Chlorhexidine
Ventilator Bundle and Oral Care Procedures
Ventilator Associated Pneumonia (VAP) is a healthcare acquired infection of concerning risk to patients who require mechanical ventilation. In fact, VAP is the most common nosocomial infection in patients who are mechanically ventilated (Barclay & Vega, 2005). The American Association of Critical Care Nurses (AACN) has recommended steps for the reduction of VAP and, when implemented together, are referred to as the “Ventilator Bundle”. These

Reflection has its importance in clinical practice; we always seek to be successful and that can be achieved by learning every day of our life through experiences we encounter. In that way we can reconsider and rethink our previous knowledge and add new learning to our knowledge base so as to inform our practice. Learning new skills does not stop upon qualifying; this should become second nature to thinking professionals as they continue their professional development throughout their careers (Jasper

The purpose of quality initiatives is to promote safe, timely, effective, efficient, equitable patient centered care( DeNisco & Barker, 2013). The quality improvement evaluation is important in the health care industry to find out the best practice care and to provide high quality cost effective care to patients. The public and private agencies are the regulatory entities in the health care Industry which promote quality and safety in the delivery of health care. The major regulatory agencies

Hygiene in Conjunction with Chlorhexidine
Evidence- Based Practice Proposal
The basis for the proposal is ventilator-associated pneumonia’s (VAP) occurrence can potentially be controlled by cautious consideration to the process of oral hygiene, where routine oral hygiene versus oral hygiene in conjunction with chlorhexidine (CHX) are examined to make sure the ideal outcomes for these patients occur.
Background
A ventilator- associated pneumonia (VAP) is a critical contamination preventable by a multitude

surgical site infections (22%), pneumonia (15%), and bloodstream infections (14%). ( book). The most common microorganisms associated with the types of infections are Esherichila coli, Enterococcus species, Staphylococcus auerus, Coagulase-negative staphylococci, or Pseudomonas aeruginosa.(secondary) Urinary tract infections occur when one or more of microorganisms enter the urinary system and affect the bladder and/or the kidneys. These infections are often associated improper catheterization technique

this type of disease has become very well known across the medical field. Nosocomial infections have also been seen within the hospitals mainly because there are workers that work in the hospital that do not practice the correct amount of hygiene regularly. As a result of this unregularly practice this is why people who do not have a disease going into the hospital, usually end up feeling a lot sicker than they did before entering the hospital. Nosocomial infections have been increasing over the years

avail them recuperate. Infections can be associated with the contrivances utilized in medical procedures, such as catheters or ventilators.
Infections may withal occur at surgery sites, CDC works to monitor and avert these infections because they are a paramount threat to patient safety.
The main types of nosocomial infections are:
• Ventilator-associated pneumonia
• Surgical site infection
• Catheter-associated Urinary Tract Infections
• Central Line-associated Bloodstream Infection
CAUSE
Nosocomial

and state laws that require reporting and infection prevention laws of HAIs, there continues to be an increase in deaths, as well as healthcare and legal costs.
Direct legal issues that result in inadequate infection-control practices, medical costs of healthcare-associated infections and the amount of deaths that have occurred due to these preventable infections are the main targeted issues that will focus on this project. Reporting requirements of HAIs vary from state to state, provider, facility

Introduction/Background
Ventilator Associated Pneumonia (VAP) is a very common hospital acquired infection, especially in pediatric intensive care units, ranking as the second most common (Foglia, Meier, & Elward, 2007). It is defined as pneumonia that develops 48 hours or more after mechanical ventilation begins. A VAP is diagnosed when new or increase infiltrate shows on chest radiograph and two or more of the following, a fever of >38.3C, leukocytosis of >12x10 9 /mL, and purulent tracheobronchial

means displaying professionalism in models of care with nursing leadership, organizational structure and evidence based practice. The American Nurses Credentialing Center (ANCC) provides a model to help aid visually with understanding the components a hospital must achieve to be considered magnet. This 5 component model was designed “to provide a framework for nursing practice and research in the future, as well as serving as a road map for organizations seeking to achieve Magnet recognition” (ANCC